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Name
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Address
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Home
Phone
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Cell
Phone
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Email
(please write clearly)
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Major
/ Year (Sr. Jr.
etc.)
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/
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List
good times to attend future club meetings (put check on boxes
that apply)
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M
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T
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W
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Th
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F
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Morn
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Morn
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Morn
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Morn
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Morn
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Mid-day
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Mid-day
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Mid-day
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Mid-day
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Mid-day
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Late-afternoon
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Late-afternoon
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Late-afternoon
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Late-afternoon
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Late-afternoon
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Have
you taken the PHR exam?
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YES __ No
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Do
you plan on taking the PHR exam?
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YES __ No
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Are
you interested in being an officer of the club?
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YES __ No
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Do
you currently have an updated resume?
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YES __ No
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How
far do you drive to campus?
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Do
you have any unique talents…. Artistic, web design etc.?
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